=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902604341
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CLAIRE ELISE LABRIE IBCLC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/03/2025
-----------------------------------------------------
Last Update Date | 03/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1072 VIRGINIA AVENUE
-----------------------------------------------------
City | CULPEPER
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-422-1971
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1072 VIRGINIA AVENUE
-----------------------------------------------------
City | CULPEPER
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-422-1971
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WL0100X
-----------------------------------------------------
Taxonomy Name | Lactation Consultant (Registered Nurse)
-----------------------------------------------------
License Number | L-152810
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------